Intraoperative rectal manometry in lipomyelomeningocele surgery

Total resection has a better long-term outcome for asymptomatic lipomas
(Pang D et al, 2009)
Lipomyelomeningocele surgery

TcMEP, SSEP, BCR
often unobtainable in infants
Sacral roots stimulation mapping does not protect detrusor function
how to avoid bladder dysfunction?

Rectal manometry (n=7)
innervation of the bladder and bowel is the same

BIPOLAR COAGULATION
CUSA

The most pronounced pressure changes were observed during the manipulations along the spinal cord-lipoma fusion line

2 month-old boy (feet paresis)
EMG (L5, S1)
before surgery:
F-waves Blocks: S-70,6%, D-77,8%
20 days after surgery:
F-waves Blocks: S-14,3%, D-7,7%
14 months after surgery:
F-waves Blocks: S-0%, D-0%